Tuesday, December 1, 2009


Steven is 4 yo who had been suffering from abdominal pain for 2 months at home in the Jimi Valley. The Jimi is far away from Kudjip, but we are the closest hospital to them. Steven's comfort at home was being carried by his father, other than that he was crying and in pain. He was too sick to play with his friends and just stayed at home.
As patients come into my exam room, I quickly classify them in my mind as not sick, sick, and very sick. I see lots of kids each day and, thankfully, many of them aren't very sick. Most kids smile and interact with me during their exam, but one look at Steven told me I was looking at a very sick kiddo. After gathering a history and doing the best physical exam I could with a screaming child, I still didn't know what he had, but was concerned it was something very bad like cancer. I ordered some blood tests and a CXR to try and narrow down my differential. When his CBC came back with an elevated WBC and low hemoglobin (anemia), I got concerned about leukemia. Thankfully, his blood cells looked normal, there were just a lot of them working to fight an infection. Once on the ward, his urine revealed the source of his infection and Dr. Susan's found a very abnormal looking L kidney. Whether it is just infection or cancer, we aren't sure, but at least now we know where his problem lies.
After giving him some blood and antibiotics he is doing better, but is still sick. I keep trying to see if he will smile, but haven't gotten him to yet. We are awaiting more blood donors and Dr. Jim will continue to evaluate him to see if he needs to take him to surgery. It is unfortunate Steven didn't come to us sooner, but I am thankful he was able to come at all. I am thankful this hospital seeks to serve the people of this area and that we do our best to care for them medically and to share the love of Christ with them. Pray for Steven, for him to respond to the antibiotics and for Dr. Jim to know when/if he needs to do surgery.